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"It gave the sign that our mission really was to help the people," said Kotcher, who lives in Mill Valley. "That we didn't have some other agenda."

With those words, Kotcher sums up the essence of Doctors Without Borders, which recently won the 1999 Nobel Peace Prize.

In awarding the prize, the Nobel Committee said the group, founded in 1971, had "adhered to the fundamental principle that all disaster victims - whether the disaster is natural or human in origin - have a right to professional assistance given as quickly and as efficiently as possible."

The committee praised the group, known internationally by its French name, M*decins Sans Fronti*res, for living up to its ideals by maintaining political independence.

"National boundaries and political circumstances or sympathies must have no influence on who is to receive humanitarian help," the committee said.

Joelle Tanguy, executive director of Doctors Without Borders in the United States, says the prize reaffirms the group's philosophy: to promptly intervene, to bring the plight of victims to the public eye, and to speak publicly when its volunteers witness violations of human rights.

"At the same time, the prize signals that the international community has a growing problem," said Tanguy, a New York resident, during a recent interview in San Francisco for this Examiner / KTVU Channel 2 report.

"As we enjoy much more prosperity in this country, we still have millions and millions of people who are questioning whether they'll be alive tonight, whether their children will be alive tonight."

Doctors without Borders, which was founded by a small group of French doctors, has 18 chapters around the world. Over the past 20 years, the group has intervened in nearly every humanitarian emergency, including the Afghan-Soviet war, the exodus of Kurdish refugees from Iraq during the Gulf War, Somalian famine, war in Bosnia, Rwandan genocide and war-related famine in southern Sudan.

Currently, Doctors Without Borders is overseeing 400 projects in more than 85 countries. Every year, it dispatches 2,000 doctors, nurses and logistics experts, who team up with local medical personnel to conduct projects.

Kotcher, a 50-year-old public health specialist, says that from a distance, it is easy to feel overwhelmed watching disasters unfold around the world.

Once she got involved, though, that feeling disappeared.

"You give what you have," Kotcher said. "Just giving somebody some hope helps alleviate a tiny bit of their suffering. It starts with compassion."

It also takes bravery. Kotcher recalls the fears she had to overcome during the mudslide disaster in Navdi two years ago.

Getting the supplies to a triage center required walking across a narrow pipe, slung 20 feet above the still-churning mudslide.

"We could have passed off the boxes to the militia and hoped they got up there, but we decided to take them up ourselves," said Kotcher, who had arrived in the central Asian country in 1997, three weeks before the mudslide.

But the people of Navdi - and two other remote villages in the rugged terrain of northeastern Tajikistan - had not.

Kotcher and a logistics expert from Doctors Without Borders had traveled to the former Soviet republic, which had been wracked by civil war, to help Tajik doctors and nurses distribute essential drugs, such as antibiotics, to 120 rural dispensaries, and launch a training program for health workers.

Kotcher made a six-month commitment to the project - the minimum required by Doctors Without Borders.

Nurse practitioner Kathy Le Fevre left San Francisco Wednesday, headed for a feeding camp in Angola set up by Doctors Without Borders.

"I don't care where I go," she said.

In Angola, Le Fevre, along with local medical personnel, will be nursing starving children back to health in intensive care clinics, and providing daily high-protein food supplements to other hungry kids.

The 52-year-old resident of San Francisco's Bayview District has served all over the world as a volunteer with Doctors Without Borders.

She tended to severely malnourished children in Bangladesh in 1992, worked in a small clinic in Cambodia in 1993, cared for sick and hungry Sudanese refugees in Uganda in 1994 and looked after drought victims in Sudan in 1998.

In between trips for Doctors Without Borders, Le Fevre works in the emergency room at San Francisco General Hospital, or at the North Bay Health Care Center in Fairfield.

Le Fevre says her throat "closed up" in shock the first time she saw starving children in a feeding camp.

"I took a couple of breaths and got to work," she said.

"Within a week, they were playing again. That's the reward."

Nancy Kennedy Sweeters, a pediatric nurse at Children's Hospital in Oakland, arrived in Nigeria in spring 1996 at the height of a cholera epidemic.

The building where Sweeters and the other volunteers set up their "cholera camp" had no running water, just pumps in the middle of the compound. No bathrooms, just pit toilets.

Quick action and a quarantine were essential.

"People die very quickly of cholera, which is very contagious," said Sweeters, 33, who lives in San Francisco's Parkside District.

The volunteers worked for eight hours, slept for eight, and returned to the camp for their next eight-hour shift.

"People come in so dehydrated they're in shock," she said. "You start an IV as fast as you can. Sometimes two. You keep hydrating them to flush out the bacteria. Usually within a few hours they're responsive. In a day or two, they can sit up."

On her days off, Sweeters helped other Doctors Without Borders volunteers conducting a massive vaccination campaign to protect people from an outbreak of meningococcal meningitis.

"At one point, we didn't have enough people coming to our station for vaccinations, but we knew there were tons of people at the market, so we took our supplies there," she said. "We probably vaccinated 8,000 people in one day."

Doctors Without Borders vaccinated 3 million people in Nigeria in only three months, she says.

As Sweeters got to know Nigerian families, she realized that they were no different than moms, dads and kids anywhere else.